Hormonal assessment before and after vasectomy.

Skegg, D. C. G.; Mathews, John D.; Guillebaud, John; Vessey, M. P.; Biswas, S.; Ferguson, K M; Kitchin, Y.; Mansfield, M. D.; Sommerville, Ian F.

doi:10.1136/bmj.1.6010.621

Cited by 44 publications

(13 citation statements)

References 10 publications

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“…In their report, Smith et al demonstrated differential changes in the hormonal levels between the first and second year after vasectomy [15]. The higher level of testosterone in azoospermia obtained in the present study is in agreement with the results of Skegg et al, who reported a greater rise in testosterone levels 6 yr after vasectomy [14]. The studies by Purvis et al, though based on a heterogenous group of 10 patients with azoospermia, showed a fall in serum estradiol and a nonsignificant rise in testosterone [ll].…”

Section: Discussionsupporting

confidence: 83%

Endocrine studies of azoospermia, II. Serum steroid levels in obstructive azoospermia

Abdalla

Ibrahim

Rizk

et al. 1979

Archives of Andrology

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Serum estrone, estradiol, estriol, progesterone, 17 a-hydroxyprogesterone, and testosterone were determined in the sera of 25 normal males and 25 patients with obstructive azoospermia. An increase in testosterone and estriol levels, and a decrease in other hormones were demonstrated in patients with obstructive azoospermia. These long-term effects of obstruction of the vas apparently also occur in comparable situations, for example, after vasectomy.Key Words: Azoosperrnia; Estrogens; Progesterones; Androgens. INTRODUCTIONInterest in the effects of prolonged obstruction of the vas on the spermatogenic and hormonal function of the testes is growing, particularly with vasectomy being performed as part of contraceptive programs implemented by many developing countries. Infertile males with obstructive azoospermia are expected to develop comparable effects. The available literature on this subject is characterized by contradiction and inconsistency. While some investigators have reported no significant changes [3, 181, others have demonstrated alterations in the hormonal function of the testes apparently related to the duration andor level of obstruction [6].This study was carried out to determine the serum levels of estrogens, progesterones, and androgens in obstructive azoospermia and to find out whether the levels are different from those in a normal control group. MATERIALS AND METHODSA group of 25 patients (26-44 yr of age) with obstructive azoospermia were selected randomly from the male infertility clinic. Their diagnosis was based on repeated semen analyses and a testicular biopsy showing active spermatogenesis. All were sexually potent and in good general health. A control group of 25 fertile males (21-40 yr of age), sexually potent and in good general health, was also included in the study. Their fertility was proved by repeated semen analyses. All had sperm counts of over 40 millionlCulm1, average motility, less than 15% abnormal forms, and ejaculate volume ranging from 1.2 to 6.7 Cu/ml. All the subjects participating in the study RESULTSThe mean values f SE for the serum levels of each of esterone, estradiol, and estriol are presented in Fig. 1, and those for serum progesterone, 17a-hydroxyprogesterone, testosterone, and dihydrotestosterone are shown in Fig. 2. In comparison to the normal group, the obstructive azoospermic group had significantly (p < 0.001) lower levels of estrone, estradiol, progesterone, 17a-hydroxyprogesterone, and dihydrotestosterone and significantly (p < 0.001) higher levels of estriol and testosterone. DISCUSSIONThe rise in total androgens and the fall in total estrogens and progesterones observed in the present study are inconsistent with the results of short-term studies reported by other investigators, which indicated insignificant changes in these hormones in vasectomized patients [3, 181. This inconsistency might be attributable to the duration and level of obstruction. In their report, Smith et al. demonstrated differential changes in the hormonal levels between the first a...

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Section: Discussionsupporting

confidence: 83%

Endocrine studies of azoospermia, II. Serum steroid levels in obstructive azoospermia

Abdalla

Ibrahim

Rizk

et al. 1979

Archives of Andrology

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“…One study, with the longest follow-up time (3 years) and largest sample, reported a statistically significant increase in the mean serum T levels of vasectomized men (Smith et al, 1979). Two case-control studies evaluated plasma T levels in non-vasectomized men and in men vasectomized from 1 to 5 years earlier (Varma et al, 1975;Skegg et al, 1976). Neither found statistically significant differences in T levels.…”

Section: Resultsmentioning

confidence: 99%

“…In one of these studies, the number of non-vasectomized men used for comparison was small (n = 16) and may not have been adequate to demonstrate a difference (Varma et al, 1975). The second study compared 188 vasectomized men with 100 men scheduled for a vasectomy and found mean T levels that were about 10% higher in the vasectomy group (Skegg et al, 1976). None of these studies examined TeBG-bc levels or indices of free T.…”

Section: Resultsmentioning

confidence: 99%

Vasectomy, cigarette smoking, and age at first sexual intercourse as risk factors for prostate cancer in middle-aged men

Honda

Bernstein²,

Ross³

et al. 1988

Br J Cancer

144

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To determine whether the association with vasectomy might have a hormonal basis, we compared levels of testosterone (T) and testosterone binding globulin-binding capacity (TeBG-bc) in 33 of the vasectomized control men with levels in 33 non-vasectomized controls of the same age, weight and height. T levels were higher in vasectomized than in non-vasectomized controls (1-sided P=0.06). The ratio of T to TeBG-bc (an index of bioavailable T) was 13.5% higher in vasectomized men (1-sided P=0.03).

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“…7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Potential biological mechanisms supporting an association between vasectomy and incident prostate cancer include increases in androgen levels, which are hypothesised to increase the risk of prostate cancer,31 and impaired secretory function of the prostate, which might prolong exposure of the prostate to carcinogenic factors 11. Although some studies have shown an increase in serum dihydrotestosterone and testosterone after vasectomy,32 33 34 others have found no statistically significant change in androgen levels 3536 Similarly, findings on the association between frequency of ejaculation and risk of prostate cancer are conflicting 37…”

Section: Introductionmentioning

confidence: 99%

Vasectomy and risk of prostate cancer: population based matched cohort study

Nayan

Hamilton

Macdonald

et al. 2016

BMJ

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Objective To determine the association between vasectomy and prostate cancer, adjusting for measures of health seeking behaviour.Design Population based matched cohort study.Setting Multiple validated healthcare databases in Ontario, Canada, 1994-2012.Participants 326 607 men aged 20 to 65 who had undergone vasectomy were identified through physician billing codes and matched 1:1 on age (within two years), year of cohort entry, comorbidity score, and geographical region to men who did not undergo a vasectomy.Main outcomes measures The primary outcome was incident prostate cancer. Secondary outcomes were prostate cancer related grade, stage, and mortality.Results 3462 incident cases of prostate cancer were identified after a median follow-up of 10.9 years: 1843 (53.2%) in the vasectomy group and 1619 (46.8%) in the non-vasectomy group. In unadjusted analysis, vasectomy was associated with a slightly increased risk of incident prostate cancer (hazard ratio 1.13, 95% confidence interval 1.05 to 1.20). After adjustment for measures of health seeking behaviour, however, no association remained (adjusted hazard ratio 1.02, 95% confidence interval 0.95 to 1.09). Moreover, no association was found between vasectomy and high grade prostate cancer (adjusted odds ratio 1.05, 95% confidence interval 0.67 to 1.66), advanced stage prostate cancer (adjusted odds ratio 1.04, 0.81 to 1.34), or mortality (adjusted hazard ratio 1.06, 0.60 to 1.85).Conclusion The findings do not support an independent association between vasectomy and prostate cancer.

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Hormonal assessment before and after vasectomy.

Cited by 44 publications

References 10 publications

Endocrine studies of azoospermia, II. Serum steroid levels in obstructive azoospermia

Endocrine studies of azoospermia, II. Serum steroid levels in obstructive azoospermia

Vasectomy, cigarette smoking, and age at first sexual intercourse as risk factors for prostate cancer in middle-aged men

Vasectomy and risk of prostate cancer: population based matched cohort study

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